Objective To compare of clinical outcomes between fresh cycle transfer and first frozen embryo transfer(FET)in patients during controlled ovarian hyperstimulation(COH)with GnRH antagonist protocol,to explore embryo transfer strategies for GnRH antagonist protocol.Methods A retrospective analysis was performed for patients using GnRH antagonist protocol at the Reproductive Medicine Center of Huzhou Maternal and Child Health Hospital,from 2017 to 2022.The patients were divided into two groups based on whether fresh embryos were transferred.Patients in the study group were treated with fresh embryo transfer(n=197),while patients in the control group were those whose whole em-bryos freezing and completed the first FET(n=136).The differences in pregnancy outcomes between the two groups were compared.Results There were no significant differences in clinical pregnancy rate(CPR,50.8％vs.54.4％,P=0.512),and live birth rate(LBR,41.1％vs.46.3％,P=0.346)between the fresh embryo transfer group and the frozen embryo transfer group in patients using GnRH antagonist protocol through univariate analysis,and also in the im-plantation rate of cleavage embryo and blastocyst(P＞0.05).The age of patients undergoing COH with GnRH antagonist protocol was the only factor predicted both CPR(RR=0.989,95％CI:0.981-0.997,P=0.007)and LBR(RR=0.992,95％CI:0.983-0.999,P=0.048)through modified Poisson regression.The fresh embryo transfer was not a factor influencing CPR(RR=1.016,95％CI:0.924-1.118,P=0.742)and LPR(RR=1.020,95％CI:0.922-1.128,P=0.700).Conclusion The age of patients is the only significant predictor of both CPR and LBR using COH with GnRH antagonist protocol,whereas fresh embryo transplantation doses not affect clinical pregnancy outcome.
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